Cardiopulmonary resuscitation, or CPR, is a lifesaving technique. It can be done by a trained layperson by performing external chest compression and rescue breathing to keep blood and oxygen flowing through the body of a victim when his or her heartbeat and breathing have stopped. CPR, done within the first 6 minutes of the heart stopping, will keep someone alive until medical help arrives.
Although rescue breathing techniques were used to revive drowning victims as early as the 18th century, it wasn't until 1960 that external cardiac massage had proven an effective revival technique, and a formal CPR program was developed by the American Heart Association. At first, CPR was taught only to physicians, but the program soon expanded to include training for the general public.
Early CPR involved separate techniques for adults, children and infants, but through the years, research has resulted in changes in how CPR is performed. In 2010, the program was revised for simplicity's sake, with CPR techniques performed in a similar manner for all age groups.
While there is no substitute for formal CPR training taught by certified instructors, the American Heart Association has recently recommended that persons who have not received CPR training initiate “hands only” CPR (without rescue breathing), because this method is easy to perform, has proven to save lives, and is better than waiting until trained help arrives on the scene.
Steps for Hands-Only CPR
1. Survey the Scene
Make sure it is safe for you to go to the victim.
2. Check the Person for Responsiveness
Shake the shoulder and ask loudly, “Are you okay?” For an infant, tap the bottom of the foot.
3. If the Person is Not Responsive, Call 911
Or ask someone else to call. If you are alone and you believe that the person is a victim of drowning, or if the victim is a child, begin CPR first, and perform for two minutes, then call 911.
4. Locate Hand Position
For adults, put the heel of one hand in the center of the victim's chest, between the nipples. Put the other hand on top of the first hand and interlock the fingers so that the fingers are drawn up and the heel of the hand remains on the chest. For children ages 1-8, use just one hand in the center of the victim's chest, between the nipples. For infants, place two fingers in the center of the chest, slightly below the nipple line.
5. Begin Compressions
For an adult, use your upper body to push straight down on the chest at least 2 inches at a rate of 100 compressions per minute, allowing the chest to recoil between compressions. For ages one to eight, push straight down on the chest about 2 inches at a rate of 100 compressions per minute, allowing the chest to recoil between compressions. For an infant, push straight down on the chest ½ to 1 inch at a rate of 100 compressions per minute, allowing the chest to recoil between compressions.
6. Continue Compressions
Until the victim starts to breathe, or until medical help arrives. If the person begins to breathe, have him lie on his side quietly until medical help arrives.
Steps for Mouth-to-Mouth Resuscitation
If you're trained in CPR, follow steps 1-5 for about 30 chest compressions. Then:
7. Open the Airway
Put the palm of your hand on the person's forehead and tilt the head back. Gently lift the chin forward with the other hand (head-tilt, chin-lift maneuver). For small children and infants, a head tilt alone will often open the airway.
8. Check for Breathing
Check by listening, looking and feeling. Check to see if the chest rises, if there are normal breath sounds (not gasping), or if you can feel the victim's breath. Do this for five to 10 seconds. If no breathing, then:
9. Give Rescue Breaths
With the airway open, for ages 1 to adult, pinch the nostrils shut and cover the person's mouth with the CPR face mask, making a seal. For infants, cover both mouth and nose with the mask. Then give two rescue breaths, each lasting for about one second. Watch for the chest to rise with the breath. If it does not rise, reposition the face mask and try again.
10. Alternate Rescue Breathing With Chest Compressions
Continue CPR, alternating 30 compressions with two rescue breaths, until the person begins to breathe, or until medical help arrives. If the person begins to breathe, have him lie on his side quietly until medical help arrives.
Remember, there is no substitute for taking a CPR class! The American Red Cross and the American Heart Association, as well as other agencies, offer CPR training as well as training in the use of an automated external defibrillator (AED). The AED is a device that can detect abnormalities in a patient's heart rhythm and, if needed, deliver an electric shock to the chest to restore normal rhythm to the heart. With training, AEDs are easy to use and are an important step in helping to revive a victim whose heart has stopped.